The negative health effects of social isolation among seniors is well documented. Senior living communities remain a source of alleviation from feelings of loneliness among seniors through active engagement, personalized care and providing a sense of belonging. Since the COVID-19 pandemic, these communities have adapted traditional models of engagement to overcome physical distancing challenges and continue to keep residents engaged.
In this exclusive discussion, esteemed industry leaders discuss the role of resident engagement technology and the future of resident engagement programming in an era of “New Resident Engagement”.
Featured panelists include:
- Benjamin Surmi, Social Gerontologist, MsG, Director of People and Culture at Koelsch Communities
- Sara Kyle, PhD., Principal LE3 Solutions, Resident Engagement Expert
- Kris Frankel, Regional VP of Engagement and Dementia Training at The Arbor Company
Note: This has been edited for brevity.
Why is resident engagement so important?
Sara: We’ve been talking about this for years and years, and it (COVID-19) has only shed more light on how important it actually is not just for a select group of people, but for everyone to be engaged. Beyond the positive health benefits, we know that the more engaged a person is the better their wellbeing but what we’re learning is that we need to figure out how we measure that engagement and its outcomes for each resident.
Kris: We’ve seen what isolation can do, and it’s really important to allow residents to live a life of passion and joy that gives them a reason to get out of the bed in the morning. Engagement can focus on so many different topics and so many different levels of interests that can provide them a sense of purpose, and without that do we, as humans, have a reason to do anything? We are social creatures who thrive on connectedness and resident engagement is one of the ways we are able to facilitate that.
Benjamin: Because there are so many answers to this question, I would like to focus on how it is important right now. Why is it so important right now when medicalization of our seniors really takes the forefront? Well, it’s because the whole reason we have to live is involved in this question of engagement. One of the basic principles of even having medical outcomes is having a purpose to live. You’re not going to recover from that hip injury if you don’t believe you’re not going to walk again. If you have a reason to get up every day, then all those medical outcomes we’re trying to reach, make sense. Engagement is key to resilience and resilience is how we survive, mentally and physically whether that’s through our relationships or how we interact with the world each day.
How has resident programming changed in the last 6 months?
Kris: When we first went into quarantine, we were doing a lot of the same things that everyone else did including activity carts and hallway activities. One thing that we’ve learned from this is that hallway activities were actually very popular, and is a format we can continue using even beyond COVID. In some cases, we learned that residents may not have been participating in their activities because they were uncomfortable being far from their apartment. For example, we’have some residents who wouldn’t participate in exercise programs because they did not want to be too far from their bathroom. By moving the exercise activity to the outside their door, we saw an increase in engagement from residentst.
Ironically, we also found we were building better connections with residents because we’ve had more time to have those one-on-one interactions and really get to know them in ways that weren’t feasible before. Arguably, we’ve been able to provide some of the best person centered care during this time and are better prepared to tailor our programs towards their likes and dislikes.
Benjamin: The key thing we learned is not only do we have a new toolbox, we have a plethora of new ways to use the tools from our old one. What COVID made us realize is that we were almost stuck in a certain mindset on how programs should be done, and COVID encouraged us to adopt a new one. For example, we have created a whole new type of programming, “apartment programming” where we are incorporating existing and new technologies to build a sense of community from the safety of a resident’s apartment. Whether that means playing bird watching bingo through a conference line or via in-room streaming on YouTube Live or even hosting Zoom meetings on topics of interest.
We’ve also been using stations where residents create a presentation of something that is important to them for others in the community to enjoy, as well as a way to build deeper relationships with one and other. Residents can engage with these stations from safe distances while partaking in something meaningful whether that’s a residents’ art show, or a staff hosted blind wine tasting. In some instances, we’ve used multiple stations in different rooms under a particular theme like, Carnival or Happy Hour, to encourage residents to move throughout in a safe, engaging way.
Ultimately, now that we have these new tools, we’re not getting rid of them.
Sara: Before Covid we often took a one-dimensional approach to programming: we scheduled, we invited, we waited for people to show up. We applied this approach to our large group programming as a way to facilitate socialization, even though we know socialization can be as minimal as two people being together. While this new “normal” of programming may not look as “engaging” when compared to the old model, what we’re seeing is that the number of people that we are able to reach is fourfold what it was. We are better positioned to deliver activities in this new model by expanding the access to participation by providing more options to engage than we ever have before.
Is technology the new normal?
Sara: I think we have to be careful about saying that “technology is the new normal”. Technology is a solution to accessibility, and to me, accessibility is the new normal and is a multi-pronged approach. That means we have to provide solutions to the barriers that prevent a person from participating in any type of engagement, whether that is addressing hearing, sight, mobility or behavioral limitations. The first step to that is identifying what are the barriers to any type of engagement. Accessibility to a family member is not just a tablet right? It’s a phone, it’s a landline, and in some cases it may be a tablet, but in others it may be an Echo or Alexa. When we say technology is the new normal, we must be mindful that there is not just one approach that is compatible to all residents and that access to a phone does not always equate to access to a family member. If a resident has hearing issues, using a phone to communicate with a family member may not be best , or someone with visual impairment may not find as much value in communicating with their loved one via tablet. We cannot put all our eggs in one basket when it comes to technology because it is not one size fits all. It’s just not as simple as ‘every resident gets a tablet’ and that is the solution that addresses each resident’s accessibility needs. Read more on how masks are barriers to effective communication during this time
In a recent study by iN2L, participants were asked to rate how important resident engagement technology investments were to their communities. When compared to responses to the same questions from a study conducted in March 2019, industry leaders who believed resident engagement technology is extremely important increased from 27% to 43%. Can you share how you view this trend and how your community plans to adapt?
Benjamin: With or without technology, there are two things that we have to consider when it comes to resident engagement: 1. How do we make in person experiences as engaging as possible and 2. how do we involve families? The senior living industry as a whole has been late to adopt technology but now with this societal shift that has given us extra leverage to implement new ways of doing things that are assisted by technology. Especially now, families are feeling disconnected from their loved ones and we’re seeing an opportunity, in an unprecedented way, to connect families to their loved ones in ways we wouldn’t have done before such as video chats across the globe.
Kris: For us (The Arbor Companies) we moved quickly to adapt our technologies. We upgraded all of our systems to larger screens and we were able to get tablets to support virtual visits. We also expanded the use of Eversound in each of our communities to help continue a level of normalcy and allow us to provide safe in person visits with quality two way communication. We’d been using Eversound to improve our programming before, but we were able to adapt our systems in new, creative ways to keep residents engaged.
We had one 98-year-old resident who was using Eversound to host prayer groups in her community, but once COVID hit she was unable to do that. However, this same resident worked with her daughter to create a virtual prayer group over Facebook that has grown exponentially. It just goes to show that residents are flexible and they can learn new things, contrary to the belief that seniors “can’t use technology”
Regardless of the technological means, we still base our strategy on how we can really get this resident to meaningfully engage and fill their time with activities that bring them a sense of purpose and many resident technologies have helped us reach those goals.
In another study, conducted by Philips and Senior Housing News in 2020, 45% of those surveyed were expecting to increase their technology adoption spend, particularly around virtual entertainment and activities for residents. Do you believe this is a trend or a fad?
Kris: I don’t know if we’ll ever go back to the old normal, honestly. Before COVID, we were looking at the older residents we have versus the younger residents and baby boomers that are coming in who are already more tech savvy. So there was that quandary there of how are we going to engage with both of them using technology because they’re at such different levels. I think COVID brought those levels closer together and pushed us to think about the ways we can use technology to benefit both of these groups.
One tactic we’ve leveraged is by using a wellbeing assessment through our Sagely program, where we’re actually asking residents what is important to them about their wellbeing, and then comparing responses to see how we can personalize programming that meets their needs. One resident may have higher spiritual needs while another may need more social interaction and through these applications were able to scale a person-centered approach to resident programming in a way that we haven’t before.
Benjamin: For us, this a trend that has just been accelerated by COVID, not a fad. Many of our communities use Eversound’s activity programming because that is something we really, really need right now as live performances are restricted. Now, one of the major benefits we’re seeing is that residents really like the idea of having access to 100s of entertainers a month, not just the one entertainer a week which is something that is here to stay.
Another engagement technology we’ve adopted is an app, Familia, that allows for family members to engage with their loved ones in various ways. Familia allows for photo-sharing between residents and loved ones, once a family experiences it–they’re hooked. These are the kinds of things that bring so much life and richness and that are not going away, even after these times.